Covid-19 Update # 41

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Current situation

As of today, April 20, Nova Scotia has 721 confirmed cases of COVID-19 in people ranging in age from under 10 to over 90.Twelve individuals are currently in hospital, four of those in ICU, and 284 individuals have recovered.

As of April 19, there were nine licensed long-term care homes and unlicensed seniors facilities in Nova Scotia with cases of COVID-19, involving 127 residents and 61 staff.

There have been 21,769 negative test results. Testing numbers are updated daily at https://novascotia.ca/coronavirus.

While most cases are connected to travel or a known case, it is known that there is community spread. Read full news release. Cases have been identified in all parts of the province. A map and graphic presentation of the case data is now available at https://novascotia.ca/coronavirus/data.

Our response

CEO Message: Take care of yourself and support each other

Today, NSHA President and CEO, Dr. Brendan Carr shared a message with staff and physicians in response to the tragic events which occurred over the weekend and to acknowledge our health care teams who cared for and supported the victims and families and will continue to do so in the days ahead. He also outlined several resources people can access for help and support at this time as they or others work through feelings around these events. These resources include our Employee Family Assistance Program (EFAP), the provincial mental health crisis line, mental health and addictions’ clinics, services and programs and Kids Help Phone. Read his full message. 

Additional resources to help cope with tragic events

The following links have been provided by Canadian Virtual Hospice to help people cope with the recent tragic events in the province:

  • MyGrief.ca – helps you understand and work through grief
  • KidsGrief.ca – “Explaining tragic world events”https://kidsgrief.ca/mod/lesson/view.php?id=141
  • MyGriefToolBox.ca – “Responding to the stresses of paramedicine”
  • These resources are all free and available online.

Upcoming session – Addressing Grief within our Healthcare Community: Mine, Yours & Ours

Join Serena Lewis and Roy Ellis, NSHA Bereavement & Grief coordinators, from 9:30 to 10:30 a.m. on April 23 as we begin the conversation of grief in our current and future workplace. This discussion will provide information on recognizing and understanding how loss is intertwined in our lives, as well as the current landscape of our community of care providing. Roy and Serena want to hear what topics will help support you as you care for yourselves, your families and within patient care. To join this session, visit https://zoom.us/j/99728453591?pwd=cVoydFpGSW5kK3VtNzRhZ1VMS3VpQT09.

Serena Lewis also spoke with CBC’s Maritime Noon about dealing with grief and shock following this weekend’s tragic events. You can listen to her interview here.   

Confirmed COVID-19 cases amongst NSHA health care workers

As of 6 p.m. today (April 20, 2020) Occupational Health Safety and Wellness (OHSW) can report the following. Please note that numbers do not include long term care workers:

  • Eastern Zone has 6 health care workers with confirmed COVID-19 
  • Northern Zone has 1 health care worker with confirmed COVID-19 
  • Central Zone has 14 health care workers with confirmed COVID-19
  • Western Zone has 0 health care workers confirmed with COVID-19

COVID-19 Risk Assessment form

The Clinical Medical Advisory Committee, in consultation with Infection Prevention and Control and clinicians across the province, have worked to create a COVID-19 Risk Assessment form.

The COVID-19 Risk Assessment is to be completed at the point of care for all patients receiving in person services from NSHA. If the patient is symptomatic or identifies as having any risk (travel outside the Maritimes, close contact of a known or suspect case, resides within a community or facility cluster) they are to be placed on droplet and contact precautions. The back of the Risk Assessment provides instructions with regards to precautions when a patient is identified as having a risk factor for COVID-19.

The COVID-19 Risk Assessment form should be placed on the front of all patient charts. This form replaces the “COVID-19 Swab form” currently in circulation.

The community and facility clusters will be identified using the Nova Scotia Public Health Epidemiology report. We will create a tab on theCOVID-19 Document Hub called Community/Facility Cluster Information (set to go live within the next two days). Community clusters and facilities will be identified by postal code. The link will also provide a script for staff and physicians to use when explaining to patients why droplet and contact precautions are required.

IM/IT is working to create a flag for patients from these clusters that will append "droplet precautions required" to their chart. This flag will activate when they are registered for appointments, triaged, or admitted to NSHA facilities. This flag will notify staff and physicians in addition to the COVID-19 Risk Assessment. Access the COVID-19 Risk Assessment form here.

PPE shipment arrives at NSHA COVID Warehouse

[Supplies] A collective sigh of relief came from the new NSHA COVID Warehouse today as shipments of personal protective equipment (PPE) were received as scheduled. In today's volatile supply chain, we are never able to count a product until it is in our hands.

Today, 1.7 million surgical masks arrived. There are now more than 2 million masks in the COVID Warehouse. Shipments of gowns and shields were also received today.

Last week we added another 240,000 gowns to the Stanfield’s order and we are about to sign a deal for a sanitizer provider. We ordered 200,000 gowns yesterday when an opportunity arose and we ordered another million masks today. 

While this is very encouraging news, we remind all staff and physicians to continue using the right PPE at the right time, both to help ensure your safety and to maintain our supply of PPEthroughout the pandemic. 

Huge thanks to our PPE Working Group and our provincial supply chain team for being prepared and persistent with ordering enough supplies to support the pandemic response now and into the future. 

Zoom for Healthcare privacy and security response

To support patient care and health care providers during the current COVID-19 pandemic, Zoom for Healthcare has been approved as a virtual care platform for use on an interim basis for all health care providers (physicians, nurse practitioners and allied health professionals).

The privacy and security of health care providers and patients/clients is our priority. NSHA, the IWK Health Centre and our government partners are working together to provide a secure on-line environment for those who are using Zoom for Healthcare to deliver care at NSHA, the IWK and in the community.

There are enhanced security features already activated in the Zoom for Healthcare application. For example, a meeting ID and password is automatically generated for every scheduled virtual meeting that only allows the health care provider and designated patient to join the meeting. Health care providers have also been given training and resources to support them in using Zoom for Healthcare securely.

To help individuals prepare for their virtual visit via Zoom for Healthcare, they will receive instructions from their health care provider in advance to ensure a secure online experience. 

To stay up-to-date about any new concerns or issues, we are continuing to monitor information about Zoom for Healthcare as it becomes available. Additional details about Zoom for Healthcare privacy and security. If you have any questions, visit https://www.cdha.nshealth.ca/telehealth-zoom or @email.

NS COVID-19 Health Research Coalition Update

The response to this funding opportunity over the past few days has been inspiring and we are grateful for the high level of interest that has already been shown. Appreciating that questions have arisen regarding the application and review processes, we have been working with Research Nova Scotia and other coalition partners to compile and update a list of frequently asked questions and answers, available here: https://researchns.ca/faq-covid19-coalition. This list will be updated on an ongoing basis. As with the call for proposals itself, we ask that you share this within our NS research community.

Healthy Corner Stores in NSHA cafeterias offering grocery essentials

Many cafeterias in NSHA facilities are stocking grocery essentials like milk, bread and fruit to help make your life a little easier during this challenging time. Download poster. 

Occupational Health/People Services

Return to Work Guidelines: Confirmed COVID-19 positive health care workers

New return to work guidelines for health care workers who are confirmed COVID-19 positive, have been developed by Occupational Health Safety & Wellness and can be reviewed here.  

Updated work criteria for asymptomatic health care workers

Occupational Health Safety & Wellness continues to collaborate with the Chief Medical Officer of Health, Infectious Disease and Infection Prevention and Control.  Based on evolving knowledge and best practices such as the universal masking policy, the work criteria for an asymptomatic health care worker deemed a contact of a positive COVID-19 case has been updated. View updated criteria.

New/Updated guidance documents and resources

  • COVID-19 Delirium Management Guide (updated link – April 20, 2020)
  • Clinical Pathway Dartmouth General Hospital COVID-19 Risk Assessment Patient Flow (updated – April 19, 2020)
  • Guide to Putting on PPE Droplet and Contact Precautions (updated – April 19, 2020)
  • Guide to Removing PPE Droplet and Contact Precautions (updated – April 19, 2020)
  • COVID-19 Assessment Chart – Mental Health and Addictions Inpatient Units (new – April 20, 2020)
  • 2SLGTQIA COVID-19 Resource Guide (updated – April 20, 2020)
  • COVID-19 Community Virtual Care Team (CCVCT) Referral Form (new – April 20, 2020)
  • COVID-19 Community Virtual Care Team (CCVCT) Patient Information(new – April 20, 2020)
  • COVID-19 Community Virtual Care Team (CCVCT) Eligibility and Referral Process – Health Care Provider Information (new – April 20, 2020)
  • COVID-19 Unit Admitting History and Physical (updated – April 20, 2020)
  • COVID-19 Information Regarding Test Results and Self-Isolation Requirements  (updated – April 20, 2020)

Hearts for health care

We’ve been hearing some messages of gratitude and support these past weeks, and we wanted to take this opportunity to share some of them with you.

“I am thinking about the healthcare professionals and the staff in the Truro facility, Colchester East Hants Health Centre, who are working, not only in the time of COVID-19, but now in the time of perhaps the worst acts of violence in our province. I hope everyone has support. Thank them and bless them for staying and doing the incredibly hard work. Take care.” – Brenda Durdle

Signs like these may be popping up at a site near you thanks to Print 101! To express their gratitude to all health care providers/workers, the company distributed signs with simple messages of gratitude and support to various sites throughout the province. 

Links/contacts

For up-to-date information, visit NSHA’s COVID-19 Hub at https://covid19hub.nshealth.ca/covid-19.

Questions can be directed to @email.